This is a continuation of grant RO1DA07109, "Developmental Effects of Prenatal Cocaine Exposure." Knowledge of the long-term consequences of prenatal exposure to cocaine is still limited by the lack of longitudinal prospective studies that follow these children out to school age. The currently funded longitudinal study (up to 30 months of age) has maintained a large sample of : 1) children exposed to cocaine: 2) to alcohol, cigarettes and/or marijuana alone; and 3) to none of these substances. This a proposal to continue to follow 307 of these subjects at 4 1/2, 5 1/2, and 7 1/2 years of age. This will permit examination of their emotional, social, and Cognitive development through the transitions to school entry and formal class work. The following questions will be addressed: 1) Does prenatal exposure to cocaine, alcohol, cigarettes, and/or marijuana, controlling for environmental and neonatal medical risk, directly affect the school-aged child's emotional and cognitive functioning?; 2) Does prenatal substance exposure interact with environmental factors to affect the school-aged child's functioning?; and 3) Is the effect of substance exposure predominately indirect, operating through mediating variables such as the child's earlier emotional regulation and environment? Answers to these questions will have implications for the most effective intervention strategies.